HomeMy WebLinkAboutMortgage_Hillard (2)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
, FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn C3709 (R71 / 6-09)
�' ,.r PresmDeO Ey Departrnerd af Lud GoremmeN Fir�nce
INSTRUCTIONS: �
To be filed in person a by mad with the CounryAuditof or Counry Recorder o! fhe wunry where tl�e pmparry is located.
Fi/ing Dates: 7J Real Property: Must file durirg Me }rear fw which the deduclion is sought. � U �
2) MobAe / Manufadumd Homes not assessed as Real Pmperty Must fiie dunng the twelve (12J months
6efoie March 31 of each year the deduction is styyAt.
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See reverse side (or ' nal instnicGons and qualification /i '�v
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Fmn Ned with:
� 5 unryAuaitor
❑ Counry Recorder
^oa1°"��OM1Bf0f "�'��°onS GIBSON COUNTY A
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app6rant, trMimm Delow
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UDITOR
� / 5' - / a/-OD 4�3a7-oa6 �'° `��l/
xt 4de6taCnm unPaid as of Mongaga / ConSaC uMe6tednes, �m7� as of Is Ihe aPP8�n1 Cro wle
tlate W ap�otion �ega� or eW�tade oM+reR
❑ Yes ❑ No
tt awrred wRh mneane a0mr Can spouse. u�dr�e xith Mwn
IS UIC P�PertY Il1 GIIPSUf%1: /�11(W2�Y ASSP�G�
. ❑ Real RoPeM1Y Q %vmimliYA�ssed . . .
ldOress of assicP+ea (wmber eM saeet �Y. smte. entl LP cotla)
Does eoohont avn D�PMY in airy ottm II yes wat muntyt
muntYinlnC"vna) ❑ Y2s-- ^ ^^ ��
�r �� �
_uz ���� �� E �
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Pcsan
NRat Tadm� Dis�?
G�Y
❑ No
a�y, Zo_ p_ �_ �_
� 6, o— ca�q oa�e c,�rn. e�r. r��
._..y ot perjury thal Ne above and faegoing infortnztim is true and cortecl and that Ne appi'uant is a residerrt ot Ind'gna and
_.., wyer of the a(aeme�rtoned property on date appfration is filed.
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